Margo Arceri of Strong’s Neck snapped this photo of two Betsy Ross flags flying at the grave siteof Patriots Selah and Anna Smith Strong at St. George’s Manor Cemetery in Setauket on a chilly Jan. 30. This version of the United States flag, rumored to have been created by Betsy Ross, was used from 1777 to 1795 and has 13 stripes with 13 stars in a circle all facing outward to represent a new constellation.

One simple lifestyle change is to make certain that those susceptible to gout attacks remain hydrated and consume plenty of fluids. Stock photo

Most risk factors are modifiable

By David Dunaief, M.D.

Dr. David Dunaief

Gout is thought of as an inflammatory arthritis. It occurs intermittently, affecting the joints, most commonly the big toe. The symptoms are acute (sudden onset) and include extremely painful, red, swollen and tender joints. In terms of symptoms, if you have ever had kidney stones, gouty arthritis is just as painful.

Uric acid (or urate) levels are directly related to the risk of gout attacks. As uric acid levels increase, there is a greater chance of urate crystal deposits in the joints. Although, and unfortunately, some patients can still experience gout attacks without high levels of uric acid.

This disease affects approximately 8.3 million people in the United States (1). This number has doubled since the 1960s. Men between 30 and 50 years old are at much higher risk for their first attack (2). For women, most gout attacks occur after menopause.

There are a number of potential causes of gout, as well as ways to prevent and treat it. The most common contributors include drugs, such as diuretic use; alcohol intake; uncontrolled hypertension (high blood pressure); obesity; and sweetened beverage and fructose intakes (3). Though heredity plays a role, these risk factors are modifiable.

The best way to prevent and treat gout is by modifying medications and lifestyle. One simple lifestyle change is to make certain, just like with kidney stone prevention, that those susceptible to gout attacks remain hydrated and consume plenty of fluids.

Just like there are medications that may cause gout, there are also medications that can treat and help prevent gout. If you do get a gout attack, NSAIDs such as indomethacin or steroids such as a Medrol pack help treat the symptoms. In terms of prevention, allopurinol helps to reduce the risk of a gout attack.

I thought we might look at gout by using a case study. I had a patient who had started a nutrient-dense, plant-based diet. Within two weeks, she had a gout episode. Initially, it was thought that her change in diet with increased plant purines might have been an exacerbating factor. Purines are substances that raise the level of uric acid. So, it is not surprising that foods with containing purines might substantiate a gout attack. However, not all purines equally raise uric acid levels.

Animal versus plant proteins

In a case-crossover (epidemiologic forward-looking) study, it was shown that purines from animal sources increase our levels of purines far more than those from plant sources (4). The risk of a gout incident was increased approximately 241 percent in the group consuming the highest amount of animal products, whereas the risk of gout was still increased for those consuming plant-rich purine substances, but by substantially less: 39 percent.

The authors believe that decreasing the use of purine-rich foods, especially from animal sources, may decrease the risk of incidences and recurrent episodes of gout. Plant-rich diets are the preferred method of consuming proteins for patients who suffer gout attacks, especially since nuts and beans are excellent sources of protein and many other nutrients.

In another study, meats — including red meat, pork and lamb — increased the risk of gout, as did seafood (5). However, purine-rich plant sources did not increase risk of gout. Low-fat dairy actually decreased the risk of gout by 21 percent. The study was a large observational study involving 49,150 men over a duration of 12 years.

There are several more studies indicating and reaffirming that plant foods do not increase the risk of gout attacks. The Mayo Clinic also suggests that plants do not increase the risk of gout. When considering my patient’s circumstances, it was unlikely that her switch to a nutrient-dense, plant-rich diet had increased her risk of gout.

Diuretics (water pills)

My patient was on a diuretic called hydrochlorothiazide for hypertension (high blood pressure). There are several medications thought to increase the risk of gout, including diuretics and chronic use of low-dose aspirin. In the ARIC study, patients who used diuretics to control blood pressure were at a 48 percent greater risk of developing gout than nonusers (6). In fact, nonusers had a 36 percent decreased risk of developing gout. This study involved 5,789 participants and had a fairly long duration of nine years. The longer the patient is treated with a diuretic, the higher the probability they will experience gout. It is likely that my patient’s diuretic contributed to her gout episode.

Vitamin C

Vitamin C may reduce gout risk. In the Physicians Follow-up Study, a 500-mg daily dose of vitamin C decreased levels of uric acid in the blood (9). However, be careful with vitamin C supplementation because it can increase the risk of kidney stones.

Medical conditions

There are a number of medical conditions that may impact the risk of gout. These include uncontrolled high blood pressure, diabetes and high cholesterol (7). My patient’s high blood pressure was under control, but she also had diabetes and high cholesterol. These disorders may have also contributed.

Obesity

Obesity, like smoking, seems to have its impact on almost every disease. In the CLUE II study, obesity was shown to not only increase the risk of gout but also to accelerate the age of onset (8). Those who were obese experienced gout three years earlier than those who were not. Even more striking is the fact that those who were obese in early adulthood had an 11-year earlier onset of gout. The study’s duration was 18 years. My patient was obese and had just started to lose some weight before the gout occurred.

Prevention

The key to success with gout lies with prevention. Patients who do get gout writhe in pain. Luckily, there are modifications that significantly reduce the risks. They involve very modest changes, such as not using medications called diuretics in patients with a history of gout; losing weight for obese patients; and substituting more plant-rich foods for meats and seafood. Increasing levels of uric acid may be a useful biomarker for indicating an increased risk of gouty arthritis attacks. However, gout attacks do occur without a rise in uric acid levels, so it is not a perfect. Although the cause of gout may be apparent to you, always check with your doctor before changing your medications or making significant lifestyle modifications, as we have learned from this case study of my patient.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

February means heart health awareness, but taking care of your heart requires a year-round commitment that has lifelong benefits. What will you do differently to take better care of your heart?

Heart disease can affect anyone, regardless of gender, age or background. That’s why all of our cardiac care experts at Stony Brook University Heart Institute remain focused on how to best prevent heart disease and heal the heart.

We fight cardiovascular disease from every angle, using the best that cardiovascular medicine can offer: risk factor prevention; state-of-the-art diagnostics, such as 3-D cardiovascular imaging; advanced minimally invasive interventions, including mitral valve repair using a patient’s own valve tissue versus an artificial heart valve; and advanced lifesaving technology, including ECMO (extracorporeal membrane oxygenation) that gives new hope to people with a serious heart or lung failure.

In the hands of our highly trained heart specialists, these and other important new state-of-the-art therapies are changing cardiac care and lives:

And while we hope that you and your family never need our acute cardiac services, you can be assured knowing that Long Island’s only accredited Chest Pain Center is right in your community. As one of only nine Chest Pain Centers statewide, Stony Brook Heart Institute is a leader in saving the lives of heart attack victims.

Since “time is muscle” when it comes to treating heart attacks, it is critical to treat patients as fast as possible, so less muscle is damaged. Stony Brook has achieved a “door-to-balloon” time, spanning the arrival at the hospital until the blockage is cleared, of 55 minutes — much better than the American College of Cardiology and the American Heart Association guidelines to open the blockage in 90 minutes or less.

And, if you suspect a heart attack, it’s best to call 911. Ambulances are equipped with defibrillators and most are equipped with 12-lead EKGs (electrocardiograms), which means they can transmit results to the hospital while en route. At Stony Brook, we assemble the treatment team and equipment you need before you arrive.

Have a question about heart disease prevention? Seeking a solution to a cardiac problem? Call us at 631-44-HEART (444-3278). We’re ready to help.

The Tax Cuts and Jobs Act increased the federal estate tax exclusion amount from $5 million to $10 million indexed for inflation for decedents dying in years 2018 to 2025. This amount is indexed for inflation back to 2011. The exact amount of the exclusion amount is not yet known for 2018. However, it is estimated to be $11.18 million. This means that an individual can leave $11.18 million and a married couple can leave $22.36 million dollars to their heirs or beneficiaries without paying any federal estate tax.

This also means that an individual or married couple can gift this same amount during their lifetime and not incur a federal gift tax. The rate for the federal estate and gift tax remains at 40 percent.

The doubling of the basic exclusion also means that the generation-skipping transfer tax (GST) exclusion is doubled to match the basic exclusion amount of $11.18 million for an individual and $22.36 million for a married couple.

The sunsetting of the doubled basic exclusion amount after 2025 raises the prospect of exclusions decreasing in 2026. Taxpayers with estates over $11.18 million will want to discuss with their estate planning attorneys the potential for making transfers to take advantage of the larger exclusion amount before the anticipated sunset.

The act does not make changes to the rules regarding step-up basis at death. That means that when you die, your heirs’ cost basis in the assets you leave them are reset to the value at your date of death.

The portability election, which allows a surviving spouse to use his or her deceased spouse’s unused federal estate and gift tax exemption, is unchanged. This means a married couple can use the full $20 million exemption (indexed for inflation). To make a portability election, a federal estate tax return must be timely filed by the executor of the deceased spouse’s estate.

In 2018, the annual gift tax exclusion has increased to $15,000. This means that an individual can give away $15,000 to any person in a calendar year ($30,000 for a married couple) without having to file a federal gift tax return.

Despite the significantly larger federal estate tax exclusion amount, New York State’s estate tax exemption for 2018 remains at $5.25 million. New York State still does not recognize portability.

With the current New York State estate tax law as enacted in 2014, there is a limited three-year look-back period for gifts made between April 1, 2014, and Jan. 1, 2019. This means that if a New York resident dies within three years of making a taxable gift, the value of the gift will be included in the decedent’s estate for purposes of computing the New York estate tax.

The following gifts are excluded from the three-year look-back: (1) gifts made when the decedent was not a New York resident; (2) gifts made by a New York resident before April 1, 2014; (3) gifts made by a New York resident on or after Jan. 1, 2019; and (4) gifts that are otherwise includible in the decedent’s estate under another provision of the federal estate tax law (that is, such gifts aren’t taxed twice).

Under the act’s provisions, most taxpayers will never pay a federal estate tax. Even with the enlarged exemption, however, there are many reasons to engage in estate planning. Those reasons include long-term care planning, tax basis planning and planning to protect your beneficiaries once they inherit the wealth.

In addition, since New York State has a separate estate tax regime with a significantly lower exclusion than that of the federal regime, it is still critical to do estate tax planning if you and/or your spouse have an estate that is potentially taxable under the New York State law.

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.

I was eating an orange the other day and got to thinking about the February some years ago when we received a crate of oranges as a gift. There was no way we could consume them all, and after I had given half of them away, I still had more oranges than we could eat. It was a bitter cold winter like this one, and as an antidote to cabin fever I did what I always do. I started cooking and concocting.

One morning it was freshly squeezed orange juice with sliced bananas; one night it was orange, fennel, radicchio and red onion salad. Another day it was orange pound cake drizzled with the orange syrup left over from making candied orange peel from all the oranges we had eaten. And there was also orange marmalade.

As it turned out, shortly thereafter, we flew south to visit the same people who had sent us the oranges. And guess what I took with me — a gift bag of bottled orange syrup, candied orange peel, a couple of jars of marmalade and an orange bundt cake. Neither cooks nor bakers themselves, they had always thought of an orange as something you peeled and ate or squeezed and drank. Period. So they were delighted withmy fancy orange by-products.

Preheat oven to 350 F. Grease a 10-inch bundt or tube cake pan. In a large bowl beat together the butter and sugar until light and fluffy; add the eggs one at a time being sure to incorporate them thoroughly in mixture. In a medium bowl sift together the flour, baking powder and salt; alternating with the orange juice, gradually beat flour mixture into butter mixture. Stir in half the candied orange peel, then pour batter into prepared pan. Bake about 55 minutes, until a cake tester inserted in center comes out clean. Remove from oven and let cool on rack about 10 minutes.

Carefully invert pan onto serving plate. While cake is cooling, make the glaze by combining the melted butter, confectioners’ sugar and remaining half of candied orange peel; stirring frequently heat over boiling water. While cake is still warm, using a two-tined meat fork, poke holes all over top of cake; then pour on glaze and allow it to run down sides of cake and seep into top. Serve warm, at room temperature or freeze for later use. Serve with whipped cream, vanilla ice cream or orange sorbet.

Candied Orange Peel

Candied Orange Peel

YIELD:Makes four to five cups

INGREDIENTS:

4 large oranges or 6 small or medium

3 cups water

4 cups sugar

DIRECTIONS:

Peel oranges and remove as much of pith as possible. Reserve the fruit of the oranges for another use. Cut peel into quarter-inch julienned strips. Cook in large pot of boiling water for 15 minutes. Drain, rinse and drain again. Meanwhile, combine 3 cups of the sugar with 3 cups water; stir and bring to a gentle boil. Add the orange peel, bring back to a boil, then reduce heat and simmer, stirring occasionally, until just tender, for 30 to 40 minutes.

With a slotted spoon remove peel from syrup and spread on cookie sheet. Reserve syrup for another use. Toss peel with remaining cup of sugar, spread out on aluminum foil or waxed paper and set aside to dry for 2 to 3 days, until slightly crunchy. Toss to expose all sides of strips to air once or twice a day. When sufficiently hardened, store in an airtight container. Serve with tea and cookies or as garnish or topping for desserts.

This week’s shelter pet is Amber, a 4-year-old Shepherd mix who came to Kent Animal Shelter from Texas with two of her pups. Her pups have since found their forever homes — now it’s Amber’s turn!Amber is a super sweet girl and loves all the attention she can get. She’s great with kids and loves belly rubs too! Amber also loves to eat, so pick up a bag of treats and come on down to visit her. She comes spayed, microchipped and is up to date on all her vaccines.

Open seven days a week from 10 a.m. to 4 p.m., Kent Animal Shelter is located at 2259 River Road in Calverton. For more information on Amber and other adoptable pets at Kent, visit www.kentanimalshelter.com or call 631-727-5731.

Over the last number of weeks we have been reminded of the seriousness of the opioid epidemic that is plaguing our country and our larger community. There have been a number of op-ed pieces in a number of respectable newspapers speaking to this issue. Our president in his State of the Union address underscored how serious this health issue is and promised all Americans that his administration is working feverishly to end this lethal health epidemic.

In Blue Point, the St. Ursula Center convent on Middle Road is for sale. A profit-making business wanted to purchase this property and use it as a residential rehab for women. After much back and forth and intense push back from the local community this business has withdrawn its offer.

Let’s be clear, we are in desperate need for residential treatment beds for people battling the heroin epidemic. We especially need more beds for women. The Ursula Center would have been ideal.

However, some rather important facts and figures were never publicly addressed that are critical to understanding the complexity of this health issue and how it must be treated if we hope to be effective supporting people who are afflicted with this addiction. There is compelling research and evidence-based treatment research that is important to review and understand. We need long-term residential treatment beds for those battling the opioid epidemic. Very few recovering opioid addicts sustain recovery after only 30 days in residential treatment.

If the truth be told, most insurance companies will not pay for any kind of residential rehab until the consumer fails at outpatient treatment. The recidivism rate for heroin addicts in outpatient treatment is off the page. People are trying outpatient treatment first because they have no choice and they are failing, they are dying — that is unconscionable.

Our insurance companies should be held accountable for every unnecessary death caused by the industry’s unwillingness to do its job. For the record most insurance companies, if they agreed to pay for residential care, only end up paying for 11 days. They decide that after 11 days it’s not a medical necessity! The average hard-core addict struggling to survive takes at least 30 to 45 days to truly detox their bodies from all the toxins with which they have been infected.

It is very disturbing that those who lead us within our political bureaucracy are unwilling to take on the insurance companies for making life-and-death decisions regarding people who battle addiction. Taking a person into residential treatment with the promise of at least 28 days and then discharging them at day 11 because the insurance company won’t pay is a disgrace and a scandal.

The Blue Point community has every right to be concerned. We do not need any more short-term residential programs that do not honor their commitments. If we’re addressing the opioid epidemic, we need long-term residential treatment programs that work on transitioning the recovering person back into the real world, hopefully with the skills to survive a drug-infested world.

The governor of our state has promised millions of dollars for residential treatment. That promise was made over a year ago. Since that promise, not one dollar has been released for residential long-term treatment.

This health crisis is getting worse by the day, not better! As a community, we need to demand the distribution of the money promised to those who are trained to work in the area of residential treatment for addiction so we can begin to support recovering addicts and their families. People are petrified and they should be; this epidemic is out of control. Change and transformation can happen and it will with the right support.

As someone who has lived and still lives with struggling drug addicts, I watch them struggle to recover. I see their pain every day but I also see the miracle of change and transformation. Addicts do recover and reclaim their lives and enrich our communities. Hope must become the anthem of our souls!

Fr. Pizzarelli, SMM, LCSW-R, ACSW, DCSW, is the director of Hope House Ministries in Port Jefferson.

Daniel Mockler in his office at Stony Brook University. Photo from SBU

By Daniel Dunaief

At first, people didn’t believe it. Now, it seems, they are eager to learn more.

Working with a talented team that included postdoctoral researchers, doctoral students and doctors, Kenneth Shroyer, the chairman of the Department of Pathology at Stony Brook University, noticed something odd about a protein that scientists thought played a supporting role, but that, as it turns out, may be much more of a villain in the cancer story.

Known as keratin 17, this protein was thought to act as a tent pole, providing structural support. That, however, isn’t the only thing it can do. The co-director of Shroyer’s lab, Luisa Escobar-Hoyos, found that this protein was prevalent in some types of cancers. What’s more, the protein seemed to be in higher concentration in a more aggressive form of the disease.

Now, working with Long Island native Daniel Mockler, a clinical assistant professor in the Department of Pathology, Shroyer and his team discovered that the presence of this particular protein has prognostic value for endocervical glandular neoplasia, suggesting the likely course of the disease.

Published in the American Journal of Clinical Pathology, the article by Mockler and his team in the Sept. 1, 2017, issue attracted the attention of pathologists around the world. It ranked as the third highest read article in the final month of 2017, according to Medscape. It was behind two other papers that were review articles, which made it the most read primary research report in pathology in December.

The response “did exceed my expectations,” Mockler stated in an email. “I would have thought [Shroyer’s earlier] paper showing that k17 can function in gene regulation would have been more popular. But I guess this [new paper] illustrates that topics that have a possible direct impact on practicing surgical pathologists will draw a lot of attention.”

To be sure, while the recent study is an early indication of the potential predictive value of this protein, there may be some mitigating factors that could affect its clinical applicability.

“It’s premature to know what the clinical utility of this marker will be,” Shroyer said. “To determine that would require a large-scale prospective clinical trial” that would involve other patient populations and other laboratories.

Still, depending on the outcome of research currently underway in Shroyer’s lab, the protein may offer a way of determining the necessary therapy for patients with the same diagnosis.

Doctors don’t want to give patients with milder version of the disease high levels of chemotherapy, which would cause uncomfortable side effects. At the same time, they want to be as aggressive as possible in treating patients whose cancers are likely a more significant threat.

“The goal of having an excellent prognostic biomarker … is to avoid over and under treatment of patients,” suggested Mockler, who is also an attending pathologist at SBU and Stony Brook Southampton.

Shroyer was delighted with the efforts of the team that put together this well-read research. “As is true of all our clinical faculty, I want to give them every opportunity to take advantage of their ability to collaborate with research faculty in our department and throughout the cancer center and the school of medicine to advance their scholarly careers and academic productivity,” he said.

Mockler’s success and the visibility of this paper is “an excellent example of how someone with a busy clinical practice can also have a major impact on translational research,” Shroyer added.

Mockler appreciated the support and work of Escobar-Hoyos, who had conducted her doctoral research in Shroyer’s lab. She has “been the main driving force, along with [Shroyer] in the initial discovery of k17 including its prognostic implications as well as its possible function in regulating gene expression,” he said.

Mockler said he spends about 80 percent of his time on patient care, with the remaining efforts divided between research and academic pursuits. His first priority is providing “excellent patient care.”

Working with Shroyer and Escobar-Hoyos, Mockler explained that they have started looking at k17 in organ systems including the esophagus, pancreas and bladder. “We are currently looking at k17 from a diagnostic point of view in regards to bladder cancer,” he said. “Discoveries that impact the daily signout of surgical pathologists by allowing us to make better and more consistent diagnoses interests me very much.”

A resident of Kings Park, Mockler, who grew up in Hicksville, lives with his fiancée Danielle Kurkowski, who is a medical technologist of flow cytometry research and development at ICON Central Laboratories in Farmingdale.

Daniel Mockler on a recent snowboarding trip to Aspen. Photo from Daniel Mockler

Outside of his work in medicine, Mockler is an avid snowboard enthusiast. He tries to get in as many trips as possible during the winter, including a vacation a few weeks ago to the Austrian Alps. A more typical trip, however, is to western mountains or to Vermont, including Killington, Okemo and Stratton.

“To blow off steam and relax, nothing is better than being on a snow-covered mountain,” he said.

Mockler is pleased with the developments in the department. He has seen the “research goals of the department change quite significantly,” adding that Shroyer has “done a tremendous amount of recruiting.”

Mockler suggests to residents that it’s “good to get involved. I always tell them that [Shroyer] has a pretty active research lab and he likes it when residents get involved.”

As for his work on k17, Mockler is pleased that he’s been able to contribute to the ongoing efforts. Shroyer “has been doing this a while and I have seen the excitement and energy he has put into k17,” he explained, “so I know that we are onto something big.”

Artist Jennifer Bardram in front of her painting. Photo by Heidi Sutton

By Heidi Sutton

The Port Jefferson Ferry House has a fitting new addition. Staff member and Port Jefferson artist Jennifer Bardram was recently commissioned by The Bridgeport& Port Jefferson Steamboat Company to create a large-scale painting to adorn the wall of the ferry house, and the result is impressive indeed. The colorful mural depicts the P.T. Barnum Ferry sailing in choppy waters on the Long Island Sound on a beautiful summer day with the Port Jefferson ferry terminal on the left and the Bridgeport ferry terminal on the right.

The artist, who prefers to paint in oils but chose acrylic due to the faster drying time, created theartwork in a realistic Americana folklore style reminiscent of famed artist Charles Wysocki. The project took approximately 120 hours over several months to complete. “I put a lot of time and heart into it and I hope I conveyed it as best as I could,” she said.

While she’s not painting, Bardram is a 15-year employee for the Bridgeport & Port Jefferson Steamboat Company and serves as supervisor and ticket agent. “How lucky are we that we have someone who is a long-term employee that can do something like this,” said Carol Koutrakos, HR/Claims Manager for the ferry. “We are very proud of her.” To see more of Bardram’s artwork, visit www.jenniferbardram.com.

When a person dies without a will, the law determines who the heirs of the estate are. Stock photo

By Linda M. Toga, Esq.

Linda Toga

THE FACTS:After my mother’s death I was approached by a man I will refer to as Joe who claims that my mother was his biological mother as well. According to Joe, before she and my father married, my mother gave birth to Joe and immediately put him up for adoption. Although Joe admits that my mother rejected his attempts to develop a relationship with her during her lifetime, Joe now claims that since my mother died without a will, he is entitled to a share of my mother’s estate.

THE QUESTION: Is Joe correct? Will my siblings and I have to share our inheritance with him?

THE ANSWER: Fortunately for you, Joe is wrong.

HOW IT WORKS: Generally a child who is adopted out does not have the right to an inheritance from the estate of his birth mother. The order of adoption generally relieves the birth parents of all parental duties and of all responsibilities for the adopted child. At the same time, the order extinguishes all parental rights of the birth parent to the estate of a child who has been adopted, including the right to serve as administrator of that child’s estate and the right to inherit under the intestacy statutes.

Although Joe seems to be relying upon the fact that your mother died without a will and, therefore, did not explicitly disinherit him, his reliance is unwarranted. That is because the New York State intestacy statute and the domestic relations law govern how your mother’s estate should be distributed.

While the child of a decedent is generally entitled to a share of his parent’s estate if the parent dies without a will [Estates, Powers and Trusts Law §4-1.1 (a)(1) and (3)], the rights of an adopted child in the estate of a birth parent are governed by subsection (d) of the statute. It provides that the Domestic Relations Law, specifically Domestic Relations Law §117, controls.

Domestic Relations Law §117 (1)(a) and (b) provide that an order of adoption relieves the birth parent of all parental duties and responsibilities and extinguishes any rights the parent would otherwise have over the adoptive child’s property or estate. At the same time, the order terminates any rights of the adoptive child to an inheritance from the birth parent.

Although there are some exceptions to these laws, the logic behind terminating inheritance rights is to prevent people in Joe’s position from enjoying a windfall by inheriting from both his birth and adoptive parents and to prevent a birth mother from receiving an inheritance from a child that she did not support during her lifetime.

Under the circumstances, the only way Joe could inherit from your mother’s estate would be if she chose to name him as a beneficiary in a will or a trust or on a beneficiary designation form. If Joe decides to pursue a claim against your mother’s estate, you should be able to defeat the claim by providing the court with evidence that Joe was legally adopted as a child.

It would be wise to retain an attorney experienced in estate administration to assist you with this matter.

Linda M. Toga provides personalized service and peace of mind to her clients in the areas of elder law, estate administration and estate planning, real estate, marital agreements and litigation. Visit her website at www.lmtogalaw.com or call 631-444-5605 to schedule a free consultation.